The specialty pharmacy fucked around and found out. I social engineered my way up the chain of command, interrupting the medical director’s dinner. They ended up hiring a courier to fly it halfway across the country. A dude showed up the doorstep at 4AM (four hours before it was needed) with a box packed with dry ice. The poor courier dude had a three hour cab ride, which probably cost more than the drug.
I made the courier and driver breakfast and coffee. The courier was fascinating, he had great stories and basically had a career mostly built on corporate screw-ups.